The Fundamental Right to Refuse

A decent society would respect people's moral commitments

The idea that, in assuming
some function -- some career, for instance -- I
resign my conscience to the institution or to the
state is perhaps the single most pernicious notion
in human history.

I am a pro-choice atheist. But I support a
regulation, recently promulgated by the Bush
administration, that would cut federal funding to
nearly 600,000 hospitals, clinics, health plans,
doctors' offices and other entities if they do not
allow their employees to opt out of providing
certain types of care -- including abortion services
-- on grounds of conscience and personal belief.

Ask yourself: What are some of the bad things
that have happened because people refused, on
conscientious grounds, to do what the institutions
in which they were embedded demanded? Now ask
yourself: What are some of the bad things that have
happened because people overcame serious qualms and
did what they were ordered to do?

The idea that we must respect individual
conscience as a moral arbiter is a fundamental
insight of the Protestant Reformation and of the
American individualism of such figures as Emerson
and Thoreau. It is at the core of our traditions and
our freedoms. This idea means nothing if we respect
it when we agree with its results and not when we
don't.

For example, many people who favor abortion
rights defended the right of healthcare providers to
dispense abortion services when it was illegal to do
so. Their argument was that women had a right to
control their own reproduction. It was, at least in
some respects, an individualist and a conscientious
argument. But if we respect the right of women to
control their bodies, we ought to respect the rights
of doctors to control their own actions. And
if we respect the decision to perform abortions, we
ought to respect the refusal to do so.

One measure of the decency and democracy inherent
in an institution is the degree to which it can
allow scope for individual conscience -- the degree
to which it allows people autonomy in fundamental
matters. The extent to which an institution seeks to
expunge individual conscience and moral autonomy is
the extent to which it is totalitarian -- and
dangerous.

Thoreau, in "Civil Disobedience," said this:
"Must the citizen ever for a moment, or in the least
degree, resign his conscience to the legislator? Why
has every man a conscience, then? I think that we
should be men first, and subjects afterward."

And he argued that although I am under no
obligation to try to fix all injustices, I am under
something like an absolute obligation to not push
forward things that I regard as unjust, to not
participate in things I regard as wrong or
gratuitously hurtful. Some doctors and nurses regard
abortion in precisely this way, taught so by their
religion or by their experiences. I don't happen to
agree with them, but the objection is clear and
principled, and it ought to be respected.

The idea that, in assuming some function -- some
career, for instance -- I resign my conscience to
the institution or to the state is perhaps the
single most pernicious notion in human history. It
is at the heart of the wars and genocides of this
century and the last. It is the first -- the only --
defense in any crimes-against-humanity trial: I was
just doing my job; I was just obeying orders.

Mobilizing a whole nation into a killing machine
for war, the Holocaust, the spasm of ethnic
cleansing, requires the idea of the supremacy of the
group and the institution over the individual. If
history teaches us nothing else, it is that this
attitude brings us face to face with the void,
nudges us into the abyss.

What will make us all essentially evil and
perhaps end life on Earth is the bland bureaucracy
with its regulations, and the willingness of people
to capitulate to it. Of course, people can refuse to
participate by quitting, fleeing and so on. But a
decent society would not require extraordinary moral
heroism; it would respect people's fundamental moral
commitments. It would keep its doctors healing, and
stop trying to force them to do what they think is
wrong.